Preoperative subconjunctival injection of mitomycin C versus conjunctival autografting with fibrin glue fixation in the management of primary pterygium

Abstract

Aims: To measure the outcome of preoperative subconjunctival mitomycin C 1 month before bare sclera and conjunctival autografting using fibrin glue in terms of recurrence rate and complications. Settings and Design: This was a prospective, randomized, interventional, hospital-based comparative study. Materials and Methods: Sixty eyes of 58 consecutive patients with primary, progressive pterygium were randomly allocated into two equal Groups (A and B) of 30 each. In Group A, subconjunctival injection of mitomycin C (MMC) (0.1 ml of 0.1 mg/ml) 1 month before bare sclera technique and in Group B pterygium excision with conjunctival autografting using fibrin glue were performed. The study period was from December 2010 to October 2012, and patients were followed up for 18 months. The outcome measures were significant corneoscleral complications and recurrence. Results: The mean age of patients in the study was 38.6 ± 12.6 years with females slightly outnumbering males. Majority (58.6%) of patients were pursuing outdoor occupations. The mean follow-up period of MMC group was 10.2 ± 4.49 months, whereas that of conjunctival autograft with glue group was 10.8 ± 3.66 months. The average surgery time was more for conjunctival autografting with fibrin glue than subconjunctival mitomycin before bare sclera. One (3.33%) patient in the MMC group and 2 (6.67%) patients in the fibrin glue group had recurrence within the study period. Both the surgical techniques were not found to be associated with any serious vision-threatening complications. Conclusions: Subconjunctival MMC 1 month before bare sclera is simple, safe, economical, less time-consuming, technically less demanding, and as effective as conjunctival autografting with fibrin glue fixation.

Keywords

• bare sclera
• conjunctival autograft
• fibrin glue
• mitomycin c
• pterygium